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ALand Disposal Restriction Page of <br /> Ala <br /> Notification Form <br /> ENVIRONMENTAL SERVICES` Printed Date :Mar 03, 2017 <br /> MANIFEST INFORMATION ----- a <br /> RMATION <br /> Generator_ City of Manteca 7 <br /> I Manifest Tracking Info. <br /> Address: 1001 West Center Street i O/ 5-� a/ / <br /> Manteca,CA 95337 <br /> EPA ID#: CAL 0 0 0 0 9 5 9 9 6 Sales Order No: 1701080820 <br /> ---- -- - -- --- —-- -- ---- — —— —— —— --------- - - - - - - ------- <br /> -Lin <br /> LINE ITEM INFOR_M_ATIO_N__ __ __ <br /> ----- ------ - <br /> - Item_ 7Page No: TProfile No: Treatability Group: I LDR Disposal Category <br /> 1 —+ —iCH13123128 —iNWWASTEWATER —I 10(Alternate Soil Std-does not meet std. <br /> - LI I 1 1(with characteristic hazardous waste only)) <br /> - ----- L-- --- -L -- - - -- - I-- - -- - - - -- - --- --- - <br /> EPA Waste Code - ------- -- - - -- - - - - -- - IEPAWasteSubCategory _ __ _ __ -- - - - <br /> D008 I Toxicity Characteristic for Lead <br /> --— — — — — — — ——— ————— ————— <br /> Certification 1 AnDlies to <br /> C2 M� - �� 9•�,,,�•_L _ -Tjjt;�: 1 Manifest Line <br /> I certify under penalty of law that I personally have examined this contaminated soil and it does not contain 1, <br /> listed hazardous waste and does exhibit a characteristic of hazardous waste and requires treatment to <br /> meet the soil treatment standards as provided by 268.49(c). 1 <br /> - -- - - - - ------------- - --- <br /> - ---- -- --- - - - ------ - -- - - - - <br /> Waste analysis data, ere ava1l a is attached. <br /> Signature : �u__ __ Print Name s S-41�il — Y I <br /> — - - <br /> Title : /-.=T-" ,� t st ��c __Date: o_�—_ _�_-�_i�L_Z�t <br /> - - - - - - - - - -- --- - -------- -- - ----- -- - - - - ------- - --- - - - <br />